When Visits to the Litter Box Increase

It’s time to check for a possible bacterial urinary tract infection, with the need for diagnosis and treatment especially urgent

Cats and people suffer many of the same illnesses, a common one being urinary tract infections (UTIs). In women, they may account for more than 6 million visits to doctors in the United States each year. Similarly, Veterinary Pet Insurance reports that urinary bladder infections — the urinary bladder is part of the urinary tract — were the most common medical condition affecting cats in claims it processed in 2012.

The fact that a cat with a UTI has plenty of company doesn’t make the condition any less uncomfortable. Nor does it make the need for treatment less urgent. Failure to treat the infections can lead to kidney infection and the formation of uroliths, or stones. Before treatment can start, however, a cat’s veterinarian must identify the cause.

Increases With Age. Most infections are bacterial and usually involve only one organism, says Andrea N. Johnston, DVM, DACVIM, a Clinical Instructor in Small Animal Internal Medicine at the Cornell University College of Veterinary Medicine Hospital for Animals. “The incidence of bacterial UTIs increases with age and in cats with chronic kidney disease. One study identified an increased incidence of bacterial UTIs in Abyssinians and spayed female cats.”

A bacterial UTI occurs when the cat’s normal defense mechanisms break down, allowing the bacteria to multiply. The bacteria travel up from the urethra into the bladder and may extend from the bladder into the kidneys. “These bacteria commonly include E. coli, Klebsiella, Proteus, Pseudomonas and Entercoccus species,” Dr. Johnston says.

Symptoms include frequent urination in small amounts — pollakiuria in veterinary parlance — straining to urinate, difficulty urinating, discolored urine, malodorous urine and inappropriate urination. One way to determine if your cat has a problem is to watch for changes in litter box behavior. “A cat with a UTI will be in the litter box much more frequently than normal,” Dr. Johnston says. And if your cat has used the litter box consistently and suddenly starts eliminating elsewhere, you should contact a veterinarian promptly.

Definitive Diagnosis. A physical examination, urinalysis and urine culture will be the first order of business. Highly alkaline urine that contains bacteria and an overabundance of white blood cells in a urine sample collected in a sterile fashion is suggestive of a UTI, but a urine culture is required for definitive diagnosis. The veterinarian will probably prescribe a course of antibiotics. Their administration usually clears up a simple bacterial infection.

It’s important for owners to continue giving their cat the antibiotic even if symptoms abate. Stopping too soon may allow residual bacteria to re-multiply. That can cause the infection’s symptoms to return and also may promote bacterial resistance during a second round of antibiotics.

Veterinarians may also recommend putting a cat on a therapeutic diet designed to prevent stones from forming in the urinary tract. Stones can irritate the urinary tract and, if they grow large enough, can block the flow of urine. If the stones become lodged in the urethra, the affected cat faces a potentially fatal veterinary emergency.

Other predisposing factors for UTIs “may be congenital abnormalities in the urinary tract, cancer, polyps, excess glucose in the urine, catheterization, prostatic disease, immunosuppressive drugs such as corticosteroids, or urine with low osmolality [number of particles dissolved in urine],” says Dr. Johnston.
The ultimate prognosis for alleviating recurring UTIs varies, depending on whether the underlying cause of the infection can be determined. A cat with a simple, first-time UTI has an excellent chance of recovery, as long as the owner makes sure he completes the full course of antibiotics. ❖

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